Encipher Health provides AI‑driven medical coding intelligence that automates the end‑to‑end coding of patient charts using its Neuro‑Symbolic AI platform, then validates results with certified CPC and CRC coders. This dual‑layer approach improves coding accuracy, cuts manual error and QA overhead, and reduces operational costs, enabling faster reimbursements and allowing clinical teams to focus on patient care.
Funding
Funding not disclosed
Founders
Product
Problem
Healthcare providers must manually code medical records for billing and risk adjustment, a process that is time‑consuming, prone to human error, and requires extensive quality‑assurance oversight.
Solution
Encipher Health applies Neuro‑Symbolic AI to automate the end‑to‑end medical coding workflow, extracting clinical concepts from charts and generating appropriate ICD‑10, CPT, and HCC codes. After AI coding, certified CPC and CRC coders perform a second‑level audit to verify accuracy and compliance. This dual‑layer approach reduces manual error, lowers QA overhead, and speeds claim submission, enabling faster reimbursements and lower operational costs. The platform supports specialty‑specific modules—including anesthesia, radiology, GI, E&M, and home health—to address diverse coding requirements. Integration points allow the solution to work within existing EMR and revenue‑cycle systems, preserving clinician workflow while improving coding precision.
Target Audience
Primary customers are hospitals, health systems, and physician practice groups that manage large volumes of medical coding for billing, risk adjustment, and compliance.
Features
- Neuro‑Symbolic AI engine that parses clinical documentation and generates coded outputs across multiple specialties
- Automated second‑level audit by certified CPC/CRC coders to validate AI‑generated codes
- Specialty‑specific modules (e.g., anesthesia time‑based billing, radiology code validation, GI procedure coding, HCC risk adjustment)
- Real‑time code validation and MEAT (Maximum Expected Accuracy and Timeliness) checks to ensure compliance
- Seamless integration with EMR and revenue‑cycle management systems via APIs
- Dashboard reporting on coding accuracy, error reduction, and reimbursement timelines